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Employee Benefits SAINT LOUIS UNIVERSITY. 2011 Annual Enrollment. Medical/Pharmacy Benefits. Annual Enrollment 2011. Highlights Effective January 1, 2011. The Vitality™ Wellness Program Save on premium and earn rewards! Health screenings are needed to participate in the Vitality program
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Employee BenefitsSAINT LOUIS UNIVERSITY 2011 Annual Enrollment
Medical/Pharmacy Benefits Annual Enrollment 2011
Highlights Effective January 1, 2011 • The Vitality™ Wellness Program • Save on premium and earn rewards! • Health screenings are needed to participate in the Vitality program • Medical changes • Lifetime maximum on both plans will be unlimited • Preventive care is covered at 100% • Pricing will be done on four tiers: Employee, Employee & Spouse, Employee & Child(ren), or Family • No Dental plan design changes • Eligibility Changes: • You can now cover adult children to age 26 regardless of student or marital status on both the medical and dental insurance • Express Scripts • Ninety-day prescriptions will no longer be available at retail pharmacies but can still be obtained via mail order • Flexible Spending Accounts (FSAs) • Over-the-counter (OTC) Medication will no longer be reimbursable under FSA programs due to Federal health care reform S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
UnitedHealthcare Plans S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
For more information on your prescription drug coverage, please visit: www.express-scripts.com UnitedHealthcare Plans S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Copays • You only have copays in THREE scenarios: • Physician office visits for SLUCare ONLY! • Both the Primary and Plus plans offer $10 primary care physician and $20 specialist office visit copays. • All other UHC in-network physician office visits are billed at the discounted rate and apply to your deductible and coinsurance • Urgent Care and Emergency Room Facilities • Both the Primary and Plus plans offer $50 urgent care facility and $100 emergency room copays both in- and out-of-network. • Rx Drugs • Both the Primary and Plus plans offer copays for Rx drugs: S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Illustrative Medical Scenario • You visit a SLUCare doctor at a UHC-contracted hospital for an inpatient surgery; $1,250 in Physician charges and $5,000 in facility charges (after UHC discounts) • PRIMARY PLAN • Doctor’s Charges: $250 deductible (SLUCare specific, cross applies to in-network deductible), then 10% coinsurance (10% x $1,000 = $100) • $250 + $100 = $350 • Facility Charges: $500 deductible (UHC in-network deductible, cross applies with SLUCare deductible; only $250 remains), then 20% coinsurance (20% x $4,750 = $950) • $250 + $950 = $1,200 • TOTAL = $1,550, leaving $950 on your out-of-pocket maximum ($900 on the SLUCare specific out-of-pocket maximum) • PLUS PLAN • Doctor’s Charges: $0 deductible (SLUCare specific), 0% coinsurance • $0 + $0 = $0 • Facility Charges: $250 deductible (UHC in-network deductible), then 10% coinsurance (10% x $4,750 = $475) • $250 + $475 = $725 • TOTAL = $725, leaving $525 on your out-of-pocket maximum S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Tips For You to Help Save Money • As an employee, you can take ownership in you and your family’s health care • Consumers can control costs by: • Using less expensive and more efficient providers (i.e., in-network) • Using appropriate providers (i.e., urgent care versus emergency room for non-emergencies) • Requesting generic prescriptions or prescriptions on lower tiers when available • Using mail order for maintenance prescriptions S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
UnitedHealthcare’s Member Website www.myuhc.com: Find participating providers Check claim status and history Learn more about your benefits Track deductibles, out-of-pocket expenses and lifetime maximums Estimate and compare treatment costs S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Medical Payroll Deductions S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Voluntary Dental Benefits Annual Enrollment 2011
Voluntary Dental Benefits Coverage will continue through Delta Dental Choose between three dental plan options Benefits will remain the same for 2011 Contributions increasing 7% S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Voluntary Dental Plan—Delta Dental S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Dental Payroll Deductions S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Flexible Spending Accounts Annual Enrollment 2011
Flexible Spending and Dependent Care Accounts Administration will remain with ConnectYourCare You must make a new election for the 2011 Plan Year; current elections cannot be carried forward Due to National Health Care Reform, as of January 1, 2011, over-the-counter (OTC) medicines are no longer eligible for purchase with an FSA unless you have a prescription from your doctor You can continue to use your FSA funds to purchase OTC items that are not considered a medicine or drug (e.g. bandages, splints, contact lens solutions, etc.) Take these new rules into consideration when estimating the dollar amount you will put in your FSA in the upcoming plan year S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Flexible Spending and Dependent Care Accounts Annual maximum for the health care FSA will remain at $5,000 Annual maximum for the Dependent Care Account Contribution will remain at $5,000 ($2,500 if married and filing separate returns) For the health care FSA, your total election amount less previous reimbursements is available at the time of transaction For the Dependent Care FSA, only the cash balance in your account is available at the time of transaction You cannot roll over unused balances from one year to the next; carefully estimate your expenses for the next plan year… especially in light of the new OTC rules S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Flexible Convenience Card • Can be used at authorized vendors (medical facilities, hospitals, pharmacies, etc.) • Allows direct payment at time of service • If you have a prescription for an OTC medication, you must pay out-of-pocket (NOT with your FSA debit / convenience card) and submit a manual claim requesting reimbursement • Cards are good for three years! • So, if you currently have a Flexible Convenience Card, hold on to it! It will be reloaded with any election you make for 2011! S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Eligible Traditional Medical FSA Expenses • Copays, co-insurance and deductibles for medical, prescription and dental plans • Eye exams, contacts and eyeglasses • Laser eye surgeries • Hearing aids • Over-the-counter medical supplies (but not medications) • Bandages, splints, contact lens solution, etc. • Insulin • Some expenses not covered by your health care plan S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Advantages of FSAs—Tax Savings Example Assumes individual filer w/federal income tax rate of 15%; example does not include state, city, or other taxes S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Annual Enrollment 2011 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
Elections Are Binding For The Plan Year Unless There Is A Life Status Change • Marriage • Birth/adoption • Divorce • Death • Change in employment status • Change in dependent status Life status change allows you to make benefit election changes and adjust your FSA elections Benefits department must be notified within 31 days of life change S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
What Next? Enrollment season is November 1st through 30th All employees must enroll or make changes through Banner Self-Service Update beneficiary information if necessary Return all materials to the benefits office no later than Tuesday, November 30th, 2010 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx